<p>Smartwatch-based monitoring prototypes may support future haemodialysis care, but their implementation requires prior assessment of acceptability and feasibility. This study analysed acceptance of a clinical smartwatch designed to monitor physiological variables and support symptom communication among patients with chronic kidney disease undergoing haemodialysis, comparing patients and nursing staff through an extended Technology Acceptance Model. This was a multicentre pilot implementation study with a quantitative design based on an extended Technology Acceptance Model. A total of 137 participants were included: 83 patients with chronic kidney disease receiving haemodialysis and 54 nursing staff. Descriptive statistics, internal consistency analyses, and exploratory assessment of relationships between technology acceptance constructs were performed and interpreted cautiously given the pilot nature of the study. The smartwatch measurements were not clinically validated in this study, were not used for clinical decision-making, and were not integrated into the dialysis workflow. Both patients and nursing staff showed high levels of acceptance of the smartwatch, with positive attitudes and strong intentions to use the device. Among patients, perceived ease of use appeared more relevant to acceptance, whereas among nursing staff, perceived usefulness seemed to play a more prominent role. Overall, the findings suggest that acceptance patterns differed according to user role and clinical context. This pilot study suggests that a smartwatch-based monitoring prototype was generally well accepted by haemodialysis patients and nursing staff. However, the findings should be interpreted as evidence of acceptability and feasibility only, and not as evidence of clinical validity, clinical effectiveness, or workflow integration.</p>